Background: Since 2006 chocolate containing psilocin is circulating in The Netherlands. Psilocin is a psychoactive substance derived from psychedelic mushrooms and known to be hard drugs. Consuming psilocin can cause symptoms such as hallucinations, fear and panic attacks and sympathomimetic effects. These effects can last for approximately 6 hours.
Case description: A man presented to the ED after eating a piece of chocolate. He was complaining of agitation, dizziness, a dry mouth and nausea. He was hypertensive and had wide light-responsive pupils. An analysis of the chocolate in the hospital pharmacy laboratory indicated the presence of psilocin.
Conclusions: Food, like chocolate, can contain toxic ingredients that are not mentioned on the ingredients lists. Therefore, in unexplained symptoms, it could be useful to exclude an intoxication with polluted food.